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Primary neonatal thalamic haemorrhage and epilepsy with continuous spike-wave during sleep: a longitudinal follow-up
J P Monteiro1, E Roulet-Perez, V Davidoff
1Neuropediatric Unit CHUV, Lausanne, Switzerland.
Insights
Neonatal thalamic hemorrhage can lead to epilepsy with continuous spike-waves during sleep (CSWS). This epilepsy, not the initial brain injury, caused later cognitive and behavioral issues in a long-term study.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Epileptology
Background:
- Neonatal thalamic hemorrhage is a significant perinatal brain injury.
- Epilepsy with continuous spike-waves during sleep (CSWS) is a rare epilepsy syndrome.
- The long-term sequelae of neonatal thalamic hemorrhage are not fully understood.
Observation:
- A case study followed a child from birth to 17 years after neonatal thalamic hemorrhage.
- The child initially had normal cognitive development.
- Behavioral problems and cognitive stagnation emerged later, correlating with epilepsy diagnosis.
Findings:
- The acquired behavioral problems and cognitive stagnation were attributed to CSWS, not the initial hemorrhage or hydrocephalus.
- Long-term follow-up suggests CSWS can be a sequel to neonatal thalamic hemorrhage.
- Thalamocortical interaction disturbances may underlie CSWS.
Implications:
- CSWS should be considered in the differential diagnosis of cognitive and behavioral changes in children with a history of neonatal thalamic hemorrhage.
- Understanding thalamocortical dysfunction is crucial for managing CSWS.
- This case highlights the importance of long-term monitoring for epilepsy development after neonatal brain injury.
Abstract:
Epilepsy with continuous spike-waves during sleep was diagnosed in a child who suffered primary neonatal thalamic haemorrhage, and who was followed from birth to 17 years of age. Early cognitive development was normal. Acquired behavioural problems and cognitive stagnation could be directly related to the epilepsy and not to the initial lesion and posthaemorrhagic hydrocephalus. This case and long-term follow-up data on a few children who suffered primary neonatal thalamic haemorrhage suggest that epilepsy with continuous spike-waves during sleep can be a sequel. Disturbances of thalamocortical interactions could play a role in the still poorly understood syndrome of epilepsy with continuous spike-waves during sleep.